Provider Demographics
NPI:1700432200
Name:FIVE STAR PHARMACY, LLC
Entity Type:Organization
Organization Name:FIVE STAR PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:662-801-2856
Mailing Address - Street 1:102 NORTHWEST PLZ
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-1729
Mailing Address - Country:US
Mailing Address - Phone:662-612-6225
Mailing Address - Fax:844-273-2027
Practice Address - Street 1:102 NORTHWEST PLZ
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-1729
Practice Address - Country:US
Practice Address - Phone:662-612-6225
Practice Address - Fax:844-273-2027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy